Program for Prevention of Mother to Children HIV – AIDS Transmision

According to the 2007 Liberia Demographic and Health Survey, the national prevalence rate of HIV/AIDS is estimated at 1.5%, while the HIV sentinel surveillance conducted among pregnant women attending antenatal clinics puts the prevalence among this population group at 5.4%. Currently, the country has succeeded in developing and implementing national guidelines for HIV testing and counselling, PMTCT guidelines, national guidelines on ART as well as draft guidelines on blood safety and testing and HIV/TB co-infection guidelines.

These tools are being used to train diverse mid-level health professionals, including medical doctors, nurses, physician assistants, etc. To date, there are 1,689 patients on ART receiving treatment at 15 centres and 961 PLWHA on prophylaxis at these sites. Additionally, there are 79 HCT sites, 25 PMTCT sites and 15 sentinel sites providing services across the country.

Since 2004, the Saint Joseph´s Catholic Hospital develops an HIV & AIDS Program in collaboration with the National AIDS Control Program (NACP), addressing the following tasks:

Voluntary counseling and testing and Provider Initiated Counseling and testing.

Anti-Retroviral (ARV) Program where drugs are given free of charge after counseling and Treatment of opportunistic infections. The ARVs and test kits are given to us by the Government of Liberia through the Global Fund.

Support Group Program.

PMTCT Program (Prevention of Mother-to-Child transmission of HIV&AIDS). Formula Program for exposed babies

Home visits.

This HIV & AIDS Program is being held both at Saint Joseph’s Catholic Hospital and at the New Kru Town Health Center.

The PMTCT Program was set up in December 2004 by Global Strategies for HIV Prevention, an NGO based in San Francisco, California, USA, with the help of the African Education Foundation. Global Strategies has become a very important contributor to Liberians´ health and we are immensely grateful.

We are requesting for financial support to enable us to do more testing and follow up of the babies since our former donor for this Program, Global Strategies for the Prevention of HIV, has withdrawn their support because, as their main objective of consolidating the program and training people in PMTCT is achieved, they focus on a different country. They have been helping us for seven years, the longest to any country.

The project was started with one doctor, two counselors, one midwife and a laboratory technician. Since December 2004 we have been testing pregnant women for HIV at the main hospital and our Health Center in New Kru Town.

All pregnant women seen at the two facilities have group pre-test counseling done by our trained HIV & AIDS counselors and midwives at the antenatal clinic, and those who agree to be tested are counseled individually before their tests are performed. Post-test counseling is done for every woman with a positive result and are given appointments to talk with the counselors on different days as the need may be. The women were at that time given two tablets of Niverapine 200 mg to take home and take one as soon as labor begins and they are encouraged to come to the hospital for delivery. Those who live far and cannot reach us on time are advised to bring the baby within the first 72 hours of delivery to get their ARVs. Following the National Guidelines, we are currently offering combinated drugs to our clients found positive.

We have had and still have some patients who are already on ARVs who became pregnant and we let them continue with their ARVs and during labor they are given AZT and Nevirapine.

From 2008 to 2011, 13, 251 people were counseled and tested, and 397 (3%) were found to be positive and were placed on ARVs according to the National Guidelines.

Number of Pregnant Women Tested from 2008 to 2011

Year

Total tested

Total positive

Percentage

2008

3,302

103

3.10%

2009

3,228

109

3.38%

2010

3,995

105

2.63%

2011

2,726

80

2.93%

From 2008 to 2011 we had 107 babies born to HIV positive mothers. All of these babies were given AZT and Nevirapine and then had DBS for PCR testing in South Africa. We were privileged to get a PCR machine and train few lab technicians on doing the testing but unfortunately the reagents and maintenance of the PCR machine is expensive and we have not been able to get it functioning. Now with the help of the National Diagnostic Unit the PCR machine will become a reference for the NACP, NDU and other institutions.

Mothers who are poor and cannot afford to get formula for their babies, after opting to formula feed, are given formula for their babies. This program is presently being sponsored by the Hospital thanks to the donations coming from Hospital San Juan de Dios of Santurce, Spain.

Our antenatal mothers are becoming more cooperative and coming in for testing and we are encouraging them.